CPR Hands Placement for Adults
Correct CPR hand placement is essential to ensure an optimal physiologic response to chest compressions. For adults, the hand position for chest compression is in the center of the chest between the nipples. Follow these chest compression steps to make sure that you are set correctly:
1. Place the heel of your one hand in the center of the chest.
2. Place the heel of the other hand directly on top, interlacing your fingers.
3. Place your shoulders directly over your hands.
4. Keep your arms straight, and push straight down, at least 2 inches deep, at a rate of 100-120 compressions per minute.
5. Allow the chest to rise fully between compressions.
6. Avoid lifting your hands completely off the chest.

During CPR, push hard and fast until you see obvious signs of life or until the emergency response team arrives and takes over. Then, if needed, deliver ventilation or rescue breaths with minimal interruptions in chest compressions. Do this until normal breathing is restored or until the emergency response team arrives for advanced medical care.
Hand Placement for Child CPR
During CPR on a child, you should place 1 or 2 hands in the center of the child's chest, between the nipples. If you become tired during compressions, use both hands to ensure you continue to reach the desired depth at a rate of 100-120 compressions per minute.
Hand Placement for Infant CPR
Hand position for chest compression in infants or children younger than 1-year-old is different. The rescuer must place two fingers in the center of the chest just below the nipple line. An infant's body is much smaller, so you only need to use two fingers for compressions instead of your hands. Aim for a compression depth of about 1.5 inches or 1/3 the depth of the child's chest, at a rate of at least 100 compressions per minute.
In the American Heart Association recommendation, rescue breathing is more important for infants and younger children. So it's essential to provide 30 compressions and two breaths. Do this until normal breathing is restored or until the emergency response team arrives for advanced medical care.

What is CPR Hand Placement?
CPR hand placement refers to the specific technique of positioning one's hands on a person's chest during cardiopulmonary resuscitation (CPR). Hand placement is an essential component of successful CPR. It is important to make sure that the hands are placed in the correct position, as incorrect hand placement can lead to inadequate depth and rate of chest compressions, as well as a greater risk of rib fractures. In order to ensure effective hand placement during CPR, healthcare providers and responders should consult with medical professionals before performing chest compressions on each patient, as well as regular practice proper hand placement and technique on a mannequin or other training device.
The Importance of Quality Chest Compressions
Chest compression is the most critical element of CPR. If someone is in cardiac arrest, their heart is either not beating or cannot circulate blood to the brain and other vital organs. Abdominal compressions squeeze the victim's heart to manually pump the heart and circulate oxygenated blood to the body.
If compressions are not performed adequately, blood circulation may not be effective. If compressions are ineffective, CPR will be useless too. On the other hand, effective chest compressions can keep a person viable until help arrives and can even get the heart beating again on its own.
What is the proper hand placement for performing chest compressions during CPR?
The proper hand placement for performing chest compressions during CPR is on the lower half of the breastbone, at the center of the patient's chest. The hands should be placed one on top of the other, with the heel of one hand resting directly on top of the other. This technique allows for greater depth and force to be applied to each compression. It is important to follow correct technique when performing CPR, as proper technique will help ensure that the patient receives effective chest compressions and a better chance for survival.
How does hand placement differ for adults, children, and infants during CPR?
For adults, the hand placement for performing chest compressions during CPR is on the lower half of the breastbone, at the center of the patient's chest. Both hands should be placed one on top of the other, with the heel of one hand resting directly on top of the other. For children, one hand may be used instead of two and should be placed in the center of the chest. When performing CPR on infants, place two fingers in the center of the chest, avoiding the use of the entire hand. It is important to use proper hand placement for all age groups, as it will help ensure that the patient receives effective chest compressions and a better chance for survival.
Does Hand Placement Affect the Quality of Chest Compressions?
Yes, hand placement during CPR significantly affects the quality of chest compressions. Proper hand placement ensures that the compressions are delivered effectively and maximize the chances of restoring blood circulation. Here's how hand placement affects the quality of chest compressions:
- Effective Compression Depth: Placing the hands correctly allows for proper compression depth. In adult CPR, the sternum should be depressed by about 2 to 2.4 inches (5 to 6 centimeters). Incorrect hand placement can result in inadequate compression depth, which might not effectively pump blood through the body.
- Avoiding Rib Fractures: Proper CPR hand placement, especially in adults, helps to minimize the risk of fracturing ribs. Placing the hands on the sternum rather than on the ribs, distributes the force of compressions more evenly, reducing the likelihood of rib fractures or injuries.
- Optimal Force Distribution: The correct CPR hand placement ensures that the force applied during chest compressions is directed to the right area, namely the heart and major blood vessels. This improves blood flow and oxygen delivery to vital organs.
- Minimizing Interruptions: Accurate CPR hand placement helps maintain consistent and uninterrupted chest compressions. Improper hand positioning may lead to frequent interruptions as responders adjust their technique or reposition their hands, potentially reducing the effectiveness of CPR.
- Circulation Enhancement: Correct CPRhand placement maximizes the chances of effectively pumping blood to the heart and brain, which is critical during cardiac arrest. Inadequate hand placement can impede blood flow and hinder oxygen delivery.
How many hands should I use during CPR?
You can use either one or two of your hands during CPR. However, more pressure is applied to the chest when using two arms. Therefore, using both hands is recommended when performing CPR on adults and children above eight. Adult bones are typically not as fragile as infants, so using two hands will help you achieve the deeper compressions you need.
Using one hand is recommended for young children between 1 and 8 years old. As for infants, you must only use two or three fingers to perform CPR because they are more fragile than pre-teens and teenagers. Too much pressure can end up breaking their bones or causing organ damage.
What is Hands-Only CPR?
Hands-only CPR involves continuous chest compressions without rescue breaths. During hands-only CPR, the hand placement remains the same as in conventional CPR. The goal of hands-only CPR aligns with that of traditional CPR: to maintain blood circulation in the victim's body until professional medical assistance arrives for more advanced life support. Hands-only CPR has been proven to be equally effective as conventional CPR.
What are the potential risks or complications associated with improper hand placement during CPR?
Improper hand placement during CPR can lead to various risks and complications that can impact the effectiveness of chest compressions and the overall outcome of the resuscitation attempt. Here are some potential risks:
- Inadequate Blood Circulation: Incorrect CPR hand placement may not effectively compress the heart and major blood vessels, resulting in insufficient blood circulation. This can lead to inadequate oxygen delivery to vital organs, worsening the person's condition.
- Reduced Compression Depth: If hands are placed too high or too low on the chest, the compression depth may be inadequate. Insufficient compression depth hampers the ability to generate the necessary pressure to move blood effectively.
- Rib Fractures and Injuries: Placing hands directly on the ribs instead of the sternum can lead to rib fractures and injuries. The force of compressions should be directed toward the sternum to minimize this risk.
- Inconsistent Compressions: Improper CPR hand placement might result in compressions that are uneven or inconsistent, interrupting the flow of blood and reducing the effectiveness of CPR.
- Organ Damage: Inadequate compression depth and improper hand positioning can lead to organ damage, particularly if there isn't enough force to push blood through the body.
- Delayed Professional Help: Focusing on correcting hand placement during the critical moments of CPR can lead to delays in calling for professional medical assistance, which is crucial for the person's survival.
- Suboptimal Recoil: Incorrect CPR hand placement can result in incomplete chest recoil between compressions. Allowing the chest to fully recoil is important to allow the heart to refill with blood before the next compression.
- Exhaustion: Improper hand placement might require more effort from the person performing CPR, leading to quicker fatigue and a decrease in the quality of chest compressions over time.
To mitigate these risks, it's essential to receive proper CPR training that covers correct hand placement, compression depth, rate, and other crucial aspects. In an emergency situation, if you're unsure about your technique, it's still better to provide chest compressions to the best of your ability while seeking professional help, rather than doing nothing.
How can healthcare providers and laypersons ensure that they are properly trained to perform CPR with correct hand placement?
Healthcare providers and laypersons can ensure that they are properly trained to perform CPR with correct hand placement by taking a certified CPR class. These classes provide instruction on the proper techniques for administering chest compressions, including the correct hand placement for adults, children, and infants. Additionally, healthcare providers and laypersons may also find it beneficial to practice their skills on a mannequin or other CPR training device to ensure that they are able to correctly perform chest compressions with proper hand placement.
What are the recommended techniques for ensuring adequate depth and rate of chest compressions during CPR?
When performing chest compressions during CPR, it is important to ensure that adequate depth and rate are being achieved. For adults, the recommended technique is to compress the chest at least 2-2.4 inches deep and at a rate of 100-120 compressions per minute. For children, the compression should be at least 2 inches deep and should be performed at a rate of 100-120 compressions per minute. For infants, the compression should be at least 1.5 inch deep and performed at a rate of 100-120 compressions per minute.
How to modify hand placement techniques to accommodate patients with specific medical conditions or anatomical variations?
Modifying hand placement techniques during CPR to accommodate patients with specific medical conditions or anatomical variations requires careful consideration and adaptability. It's important to prioritize the person's safety and effective chest compressions. Here are some guidelines:
CPR Hand Placement for Obese
For obese or patients with a larger build, place the hands slightly higher on the chest to ensure proper compression depth. If necessary, use more force to achieve the recommended compression depth while being mindful of not causing harm.
Pregnant
For pregnant, position the hands a bit higher on the sternum to avoid putting excessive pressure on the abdomen and fetus. Use gentle, controlled compressions to prevent harm to the pregnant person and the unborn child.
Elderly Patients
Be cautious with the force applied during compressions, as older individuals may have more fragile ribs. Ensure proper hand placement to avoid rib fractures.
Patients with Frail Bones
Place hands gently and accurately to minimize the risk of fractures or injuries to fragile bones. Consider using slightly shallower compressions to reduce the pressure applied.
Patients with Chest Deformities
Adjust hand placement based on the deformity. Avoid putting pressure directly on protruding areas. Focus on compressing the sternum to maintain blood flow.
Patients with Implanted Devices
If there's an implanted device (such as a pacemaker or implantable cardioverter-defibrillator), compress just above the device to avoid damaging it. Check for any specific guidelines provided by medical professionals regarding CPR for patients with implanted devices.
Patients with Medical Conditions
If the patient has a known medical condition that affects the chest or ribs, communicate with medical professionals, if possible, for guidance on CPR hand placement. Modify your technique as needed to accommodate the condition while still aiming for effective compressions.
What role does feedback technology play in optimizing hand placement and technique during CPR?
In CPR, feedback technology significantly enhances the optimization of hand placement and technique. For example, feedback devices such as pressure sensors or accelerometers can be used to measure the depth and rate of chest compressions, providing real-time feedback on the quality of chest compressions. This technology can help healthcare providers and responders to quickly identify any issues with hand placement or technique so that they can make adjustments in order to provide the best possible care for their patients.
What are the recommended steps for ensuring proper hand placement and technique when performing CPR in various settings, such as in a hospital or out-of-hospital setting?
When performing CPR in various settings, such as in a hospital or out-of-hospital setting, it is important to make sure that proper hand placement and technique are being used.
- In a hospital setting, healthcare providers should consult with medical professionals to ensure that the correct CPR hand placement is being used for each patient. Additionally, healthcare providers should follow any specific instructions provided by the medical staff regarding hand placement and technique.
- In an out-of-hospital setting, responders should consult with their local first aid or CPR provider for instruction on the proper CPR hand placement and technique for administering chest compressions.
Additionally, it is important to practice these skills on a mannequin or other training device in order to ensure that they are able to correctly perform chest compressions with proper hand placement.
What are some common mistakes or errors in hand placement during CPR?
One of the most common mistakes or errors in hand placement during CPR is placing the hands too high on the chest. This can lead to inadequate depth and force during chest compressions, as well as a greater risk of rib fractures. In order to avoid this, healthcare providers and responders should ensure that their hands are placed just below the nipples for adults, children, and infants. Additionally, it is important to ensure that the hands are placed in line with the patient’s nipples, as this will help to ensure that chest compressions are administered at the correct depth and rate.
How can healthcare providers and responders work together to ensure consistent and effective hand placement during CPR in emergency situations?
Healthcare providers and responders can work together to ensure consistent and effective hand placement during CPR in emergency situations by following the same steps and procedures. This includes consulting with medical professionals before performing chest compressions on each patient, as well as regularly practicing proper hand placement and technique on a mannequin or other training device.
Additionally, healthcare providers should provide clear instructions to responders regarding proper hand placement and technique, as well as provide feedback on their performance. By following these steps, healthcare providers and responders can ensure that they are consistently delivering high-quality chest compressions with proper hand placement in emergency situations.
